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Antihypertensive medication use is highly prevalent among older adults, with treatment patterns evolving over time. This study examines trends in antihypertensive medication use in the general population and among treated hypertensive individuals aged 66-79 years, based on two nationwide German population-based surveys conducted in 2008-2011 and 2021-2023. Data were derived from the German Health Interview and Examination Survey for Adults (DEGS1; n = 1733) and the Study on Health of Older People in Germany (Gesundheit 65+; n = 680). Both surveys provide comparable information on antihypertensive drug classes-angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), diuretics, beta-blockers, and others-as well as blood pressure (BP) control (<140/90 mmHg) assessed using standardized oscillometric measurements. The prevalence of antihypertensive medication use in the general population remained relatively stable between 2008-2011 (68.7%) and 2021-2023 (64.5%). However, treatment patterns changed, with decreased use of diuretics and ACE inhibitors and increased use of ARB. Among treated hypertensive individuals, BP control remained largely unchanged at approximately two-thirds (69.1% vs. 63.6%). Notably, there was a shift from single-pill combination therapy toward monotherapy, accompanied by a decline in BP control among women (73.8%-58.0%). Overall, approximately two-thirds of adults aged 66-79 years in Germany use antihypertensive medication. Over the past decade, BP control has not improved among treated hypertensive men and has worsened among women. Furthermore, the use of single-pill combination therapies remains low and has declined among treated hypertensive individuals.